Principal Investigator/Program Director (Last, First, Middle): Jafar, Tazeen H Project Summary / Abstract Pakistan is a developing Indo Asian country facing an epidemic of chronic diseases including hypertension, diabetes, and chronic kidney disease (CKD). Adverse outcomes of CKD include kidney failure, cardiovascular disease (CVD) and death, which can be prevented or delayed, in part, by early diagnosis and treatment. Unfortunately, CKD is underdiagnosed and undertreated, in part, due to difficulty in detecting reduced kidney function. GFR is accepted as the best measure of kidney function, which can be estimated from serum creatinine, age, gender, and race using estimating equations. However, there are limitations of the existing equations and none have been validated in the Indo Asian population (India, Pakistan, Bangladesh, SriLanka), which accounts for about a fifth of the world's population. We propose a population-based cross sectional study on 500 Pakistani subjects aged 40 years or over. We will perform rigorous statistical analysis of standardized laboratory measures and socio-demographic data to develop and validate GFR estimation equations in this population. The specific aims of the proposal are: 1. To measure GFR in a Pakistani population and collect data on socio-demographic factors that might relate to variation in GFR across populations. 2. To evaluate existing GFR estimation equations in a Pakistani population 3. To develop and validate a new GFR equation specific to a Pakistani population, and compare its performance to existing equations with respect to bias, precision, accuracy. The parent grant to Tufts-New England Medical Center is for development and validation new and GFR estimation equations from large databases from North America and Europe. The proposed FIRCA to Aga Khan University would extend the results of these investigations to the Indo Asian population. The investigators have a track record of a very successful FIRCA collaboration leading to dissemination of results in leading medical journals and incorporation in health care policy in Pakistan. The best equation identified in the proposed study would serve as a valuable tool in CKD screening, and would aid the development of a national program for detection and prevention of CKD in Pakistan. Principal Investigator/Program Director (Last, First, Middle): Jafar, Tazeen H Narrative The proposed project aims to develop a valid glomerular filtration rate estimation equation in the Pakistani population that would serve as a valuable tool in chronic kidney disease screening and prevention programs in Indo Asian populations.